In this study, we determined the average glandular dose (AGD) from the craniocaudal (CC) and mediolateral oblique (MLO) views of 496 breasts (247 women) at eight clinics in Sudan. The incident air kerma from the X-ray tube output values and typical patient-specific breast exposure factors were measured. AGD values were inferred from the measured incident air kerma and breast-specific dose conversion coefficients. The AGD per CC and MLO projection and per woman ranged from 0.34–5.3 mGy (average: 2.46), 0.29–3.39 mGy (average: 1.50), and 0.6–7.4 mGy (average: 3.95). The proposed national diagnostic reference levels (mGy) are 3.48, 2.03, and 6.44 mGy for CC, MLO, and per woman, respectively. Establishing the proposed diagnostic reference levels is an essential step in ensuring patient protection from radiation and will help promote dose optimization for X-ray mammography at the national levels and beyond. The results provide important baseline data that can be used to formulate the national diagnostic reference levels.